Individual
JUSTIN RYAN CHRASTINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LMSW
Contact information
Practice address
729 SE MAIN ST, SIMPSONVILLE, SC 29681-3218
(864) 361-6873
Mailing address
729 SE MAIN ST, SIMPSONVILLE, SC 29681-3218
(864) 361-6873
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12844
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12844
SC BOARD OF SOCIAL WORK EXAMINERS
SC
Enumeration date
06/28/2021
Last updated
09/26/2021
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